Learning from development of a third-party patient-oriented application using Australian national personal health records system

Background: Large-scale national level Personal Health Record (PHR) has been implemented in Australia. However, usability, data quality and poor functionalities have resulted in low utility affecting enrollment and participation rates by both patients and clinicians alike. Development of new applications deriving secondary utility of data can enhance use of PHR’s but there is limited understanding on processes involved in development of third-party applications with nationally run PHRs. Methods: Analysis of processes and regulatory requirements for developing applications of data from My Health Record, Australia’s nationally run PHR and subsequently implementation of a patient oriented software application using data sourced from My Health Record. Synthesis of learning’s from implementation experience into recommendations for improving third party application development with nationally run personal health records. Results: The study revealed a nuanced understanding of different data types and quality of data in My Health Record and complexities associated with developing secondary use applications. Regulatory requirements associated with utilization of My Health Record data, restrictions on visualizations of data and processes of testing third-party applications were addressed to develop healthtimeline application, the first My Health Record data based open source application aimed at both patients and clinicians. Healthtimeline application translates Medicare claims records stored in myhealhthrecords into a clinically meaningful timeline visualization of historical data. Conclusions: This study demonstrated processes involved in development of an application utilizing data in Australia nationally run PHR, My Health Record. The study identified several process, technical and regulatory barriers which if addressed have the potential to make My Health Record an attractive platform for many application developers resulting in a thriving ecosystem of applications.